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Ambulance, what's the emergency?
2
00:00:02,600 --> 00:00:05,160
We're at Southport.
OK.
3
00:00:05,280 --> 00:00:09,200
The Gold Coast,
where the lights burn bright
4
00:00:09,320 --> 00:00:11,520
and the sunshine never ends.
5
00:00:11,640 --> 00:00:14,040
While many Aussies call it home...
6
00:00:15,280 --> 00:00:17,600
..every year 12 million tourists
7
00:00:17,720 --> 00:00:21,560
come to play on this stretch
of golden coastline.
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00:00:21,680 --> 00:00:26,240
He was surfing when he got bitten
on both legs by a shark.
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00:00:26,360 --> 00:00:28,040
I don't think
I'm going in the sea again.
10
00:00:28,160 --> 00:00:31,560
But the good times...
We need some medical staff.
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00:00:31,680 --> 00:00:34,640
..can often turn ugly...
Pelvic binder on him, OK?
12
00:00:34,760 --> 00:00:37,640
..and when they do...
You've had a heart attack.
13
00:00:37,760 --> 00:00:40,400
..these are the people
you want on your side.
14
00:00:40,520 --> 00:00:42,720
This is Princess Charlotte,
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00:00:42,840 --> 00:00:45,440
so we've got her a room with a view.
Good.
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00:00:45,560 --> 00:00:47,440
This guy doesn't die,
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00:00:47,560 --> 00:00:50,280
there's a good chance he's gonna end
up with a horrible brain injury.
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00:00:50,320 --> 00:00:51,960
Whether you are just visiting...
Love you.
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00:00:52,000 --> 00:00:53,000
..or you live here...
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00:00:53,040 --> 00:00:54,816
This dude seriously got
attacked by a buffalo.
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00:00:54,840 --> 00:00:56,040
She's biting me.
22
00:00:56,160 --> 00:00:57,320
(GASPS)
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00:00:57,440 --> 00:00:59,640
Are we getting any sort of
a blood pressure out of this?
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00:00:59,720 --> 00:01:02,520
We could still lose this leg.
..these are the real stories...
25
00:01:02,640 --> 00:01:04,080
You OK?
Yep.
26
00:01:04,200 --> 00:01:05,680
..of the cutting edge
medical teams...
27
00:01:05,720 --> 00:01:06,960
Do not move your head.
28
00:01:07,080 --> 00:01:09,320
We need to go in and get that
caught out straight away.
29
00:01:09,440 --> 00:01:11,680
Good work, guys.
..who pick you up...
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00:01:11,800 --> 00:01:12,800
OK, just keep moving.
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You may get some chest pain.
We're inflating the balloon now.
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..patch you up...
33
00:01:16,880 --> 00:01:18,040
Superpower!
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The fairy dust's very magical
and it fixes all sorts of things.
35
00:01:22,200 --> 00:01:24,600
..and put you back in paradise.
36
00:01:26,120 --> 00:01:27,840
Where else would you rather be?
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Tonight on Gold Coast Medical.
38
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The ball came through
and just hit me.
39
00:01:35,600 --> 00:01:37,440
An elite young sports star
40
00:01:37,560 --> 00:01:39,680
faces a future without footie...
41
00:01:39,800 --> 00:01:43,040
The other option is
taking your eye away.
42
00:01:43,160 --> 00:01:45,960
..cutting-edge surgery
to save Dave's leg...
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00:01:46,080 --> 00:01:48,096
Whenever you tinker with
the blood supply to the leg,
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00:01:48,120 --> 00:01:49,680
there's a chance
of things going wrong.
45
00:01:49,800 --> 00:01:52,520
..calls on some super-sized
spare parts.
46
00:01:52,640 --> 00:01:53,640
Wow!
47
00:01:54,720 --> 00:01:57,240
..and eight-year-old
Jack's thumb won't bend,
48
00:01:57,360 --> 00:01:59,600
and his sister has had enough.
49
00:01:59,720 --> 00:02:01,896
It's basically like having
a two-year-old all over again.
50
00:02:01,920 --> 00:02:05,080
It's time for some
miracle microsurgery.
51
00:02:05,200 --> 00:02:07,720
It'll be like a Spiderman scar.
Oh!
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♪ Catch the sun
53
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♪ Before it's gone
54
00:02:20,080 --> 00:02:23,320
♪ Here it comes
55
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♪ Up in smoke and gone. ♪
56
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(SIRENS BLARE)
57
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Heart disease is Australia's biggest
killer. A cardiac crisis
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can happen anywhere, any time and
for tens of thousands of Aussies,
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00:02:39,400 --> 00:02:44,640
their survival will depend
on an effective emergency response.
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00:02:44,760 --> 00:02:48,120
What's the town or suburb
of your emergency?
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Ah! Oh, I'm so upset.
Quickly, we're at Southport.
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00:02:52,120 --> 00:02:56,920
OK. On Southport... Now calm down
for me, whereabouts in Southport?
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00:02:57,040 --> 00:02:59,440
It's at the workplace.
It's the workplace.
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Please call the ambulance.
65
00:03:00,840 --> 00:03:03,360
The ambulance is on the way,
I need you to take a breath for me
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00:03:03,480 --> 00:03:05,000
and tell me exactly what's happened.
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00:03:05,120 --> 00:03:06,560
He's blue.
OK.
68
00:03:06,680 --> 00:03:07,960
He's not there. He's not there.
69
00:03:08,080 --> 00:03:09,840
OK, how old is he?
He's about 60...
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00:03:09,960 --> 00:03:11,840
OK. Is he awake?
No.
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00:03:11,960 --> 00:03:13,400
Is he breathing?
No.
72
00:03:13,520 --> 00:03:18,120
With no breath and no pulse,
the man is minutes from death.
73
00:03:18,240 --> 00:03:20,520
Inside the hospital's
emergency department,
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00:03:20,640 --> 00:03:23,360
Doctor Louisa Saunders
leads the team
75
00:03:23,480 --> 00:03:25,600
preparing for the incoming patient.
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00:03:25,720 --> 00:03:28,080
So we've got a 60-year-old bloke
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00:03:28,200 --> 00:03:29,400
who has had a cardiac arrest.
78
00:03:29,520 --> 00:03:32,240
We're gonna stabilise him, make sure
he's getting properly ventilated
79
00:03:32,360 --> 00:03:33,816
which may mean putting
him off to sleep
80
00:03:33,840 --> 00:03:36,296
putting a tube down his throat
and settling up on a ventilator.
81
00:03:36,320 --> 00:03:39,400
Make sure his heart
keeps going and then
82
00:03:39,520 --> 00:03:40,600
figure out what's going on.
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00:03:40,640 --> 00:03:44,160
The ambo has got to the man
in around four minutes and were
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00:03:44,280 --> 00:03:48,800
able to get his heart going with
a single shock from a defibrillator.
85
00:03:48,920 --> 00:03:52,560
He's got a pulse but it's weak
and it's way out of rhythm.
86
00:03:54,680 --> 00:03:56,760
First name is Russell,
87
00:03:56,880 --> 00:03:59,840
collapsed at work on
arrival in his VF.
88
00:03:59,960 --> 00:04:05,280
Shocked once at 200
with a change in rhythm.
89
00:04:05,400 --> 00:04:09,560
ECG show into your lateral, semi.
90
00:04:09,680 --> 00:04:13,160
The paramedics' scan of Russell's
heart suggests a blockage has
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00:04:13,280 --> 00:04:15,760
cut off blood supply
to part of his heart muscle.
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00:04:15,880 --> 00:04:17,200
Smoker is the only history
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00:04:17,320 --> 00:04:19,000
that we know.
Right.
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00:04:20,480 --> 00:04:23,000
As soon as Russell's
airway is controlled,
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00:04:23,120 --> 00:04:25,480
he's rushed to the catheter lab,
where a team is
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00:04:25,600 --> 00:04:28,920
preparing to try and clear
the blockage and save his life.
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00:04:38,200 --> 00:04:40,720
♪ What doesn't kill
you makes you stronger
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♪ Stand a little taller
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00:04:43,000 --> 00:04:46,040
♪ Doesn't mean I'm lonely
when I'm alone. ♪
100
00:04:46,160 --> 00:04:49,840
16-year-old Cooper is footie mad,
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00:04:49,960 --> 00:04:53,240
and so too is the rest of his
family. His dad, Craig, coaches both
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00:04:53,360 --> 00:04:55,960
Cooper and his brother Logan
in their local team,
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00:04:56,080 --> 00:04:58,240
the Parkwood Sharks.
104
00:04:58,360 --> 00:04:59,840
OK. Bring it in, guys. Let's go.
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00:04:59,960 --> 00:05:04,480
And his older brother, Jared, plays
in the NRL for the Brisbane Broncos.
106
00:05:04,600 --> 00:05:05,600
♪ Stronger
107
00:05:05,720 --> 00:05:07,520
♪ Stand a little taller. ♪
108
00:05:07,640 --> 00:05:08,960
These days, though,
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00:05:09,080 --> 00:05:12,640
Cooper has to work extra
hard keeping his eye on the ball.
110
00:05:12,760 --> 00:05:15,480
You couldn't see that ball coming,
that was your good side.
111
00:05:15,600 --> 00:05:17,600
The hardest part is
trying to catch the ball.
112
00:05:17,720 --> 00:05:23,040
Six weeks ago, Cooper lost the sight
in his right eye in a nasty accident
113
00:05:23,160 --> 00:05:26,880
involving a golf ball
at the driving range with his mates.
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00:05:27,000 --> 00:05:29,360
I was hit and then I let go
of my club by accident.
115
00:05:29,480 --> 00:05:31,520
I went to pick it up.
I turned around
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00:05:31,640 --> 00:05:35,600
and as I turned round the ball
came through and just hit me,
117
00:05:35,720 --> 00:05:39,840
ruptured my eyeball. So the eye
must've been open when it hit me
118
00:05:39,960 --> 00:05:44,880
and then I sort of just turned
around and fell on one knee,
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00:05:45,000 --> 00:05:49,680
and then got up and just asked
one of the boys for a jumper
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00:05:49,800 --> 00:05:51,056
or something just to put over it,
121
00:05:51,080 --> 00:05:52,840
'cause there was blood
coming out everywhere.
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00:05:52,880 --> 00:05:56,520
When the call came through telling
Craig that one of his sons had
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00:05:56,640 --> 00:06:00,640
been hurt playing sport, it was
nothing out of the ordinary.
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00:06:00,760 --> 00:06:03,160
I just thought, you know,
hit in the eye with a ball.
125
00:06:03,280 --> 00:06:04,640
Broken cheekbone, whatever.
126
00:06:04,760 --> 00:06:08,080
And it wasn't until the ambos
actually got there that...
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00:06:08,200 --> 00:06:12,400
When one of them actually opened it
I knew it was serious 'cause it
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00:06:12,520 --> 00:06:15,760
sort of gushed out with a bit of
blood and so it was pretty horrific.
129
00:06:15,880 --> 00:06:19,680
The impact from a golf ball
driven off the tee by one
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00:06:19,800 --> 00:06:24,120
of his mates literally split
Cooper's eye in half.
131
00:06:24,240 --> 00:06:27,320
For four hours,
surgeons tried to save the eye
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00:06:27,440 --> 00:06:29,600
but the damage was too great.
133
00:06:29,720 --> 00:06:32,760
They ask you if you've got any
questions but you don't know
134
00:06:32,880 --> 00:06:33,936
if you've got any questions,
135
00:06:33,960 --> 00:06:36,640
because you don't know what
you should be asking.
136
00:06:36,760 --> 00:06:39,960
To lose your sight,
it's such a permanent thing.
137
00:06:40,080 --> 00:06:44,320
At that stage we hadn't told him
what was going on either.
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00:06:47,000 --> 00:06:48,000
So...
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00:06:50,600 --> 00:06:53,560
It's been a tough six weeks
for Cooper's mum, Sharon,
140
00:06:53,680 --> 00:06:55,400
who is still trying to come to terms
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00:06:55,520 --> 00:06:58,160
with what happens
to her precious son.
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00:06:58,280 --> 00:07:00,160
It's about protecting him
143
00:07:00,280 --> 00:07:04,440
and just making sure that he's OK
and just being strong for them.
144
00:07:25,000 --> 00:07:28,000
Gold Coast University Hospital
is a training hospital.
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00:07:28,120 --> 00:07:30,080
Has the rehab consult gone in?
146
00:07:30,200 --> 00:07:33,000
That means that working alongside
the huge team of doctors
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is the next generation
of medical professionals.
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We're unique in Australia
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in the fact that we have
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00:07:39,400 --> 00:07:41,120
two medical schools that we provide
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00:07:41,240 --> 00:07:42,256
undergraduate training for.
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He's doing very well,
he's getting up and about.
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I spend a significant amount
of my time with my direct trainees,
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teaching them the craft,
if you like, or vascular surgery.
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We also spend a fair bit
time with undergraduates,
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teaching them how to be doctors,
and then also preparing
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00:07:58,280 --> 00:08:01,600
the brand-new doctors for perhaps
specialist training later on.
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00:08:04,000 --> 00:08:05,680
As he does his rounds on the ward...
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00:08:05,800 --> 00:08:08,160
Good morning. Morning!
Ah! Good morning, all.
160
00:08:08,280 --> 00:08:10,640
..Doctor Will Butcher
introduces his students to
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00:08:10,760 --> 00:08:13,400
a vascular surgeon's
classic customer -
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00:08:13,520 --> 00:08:16,840
62-year-old bricklayer Dave.
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00:08:16,960 --> 00:08:21,360
He came into hospital a day
or so ago with some black toes.
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This has happened because the blood
supply to his left foot
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has been cut off at
a couple of levels.
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00:08:28,000 --> 00:08:31,440
The onset of gangrene in his toes
came as a shock to Dave.
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00:08:31,560 --> 00:08:32,560
Three weeks ago,
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00:08:32,640 --> 00:08:36,120
my foot swelled up and started
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00:08:36,240 --> 00:08:38,320
to look like what you see
on the cigarette packet.
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00:08:38,440 --> 00:08:40,840
But Will has seen this
problem plenty of times
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00:08:40,960 --> 00:08:43,960
in his 25 years as a surgeon.
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00:08:44,080 --> 00:08:45,976
My experience is a lot
of lay people who look at those
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00:08:46,000 --> 00:08:48,656
photographs on cigarette packages
kind of go, "These are dressed up,
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00:08:48,680 --> 00:08:50,600
"specifically," and you'll see
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that his foot's in fact
not dressed up at all.
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And that is what it
looks like, really.
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And it's no surprise.
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Probably a packet a day.
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Except when I was at work,
180
00:09:01,520 --> 00:09:04,880
and probably two packs,
a packet and a half.
181
00:09:05,000 --> 00:09:07,960
'Cause by a bridge you always
got a fag in your mouth
182
00:09:08,080 --> 00:09:09,080
and talking to someone
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00:09:09,120 --> 00:09:12,120
and working and a fag
in your mouth again.
184
00:09:12,240 --> 00:09:13,600
So...
So how are you doing?
185
00:09:13,720 --> 00:09:16,200
Alright. Yeah, I feel well.
You all ready for this afternoon?
186
00:09:16,320 --> 00:09:18,040
Evidently, yeah, I am. Yeah.
187
00:09:18,160 --> 00:09:21,600
In a few hours, Doctor Butcher will
try to repair the damage that
188
00:09:21,720 --> 00:09:24,880
a lifetime of heavy smoking
has done to Dave's arteries.
189
00:09:33,600 --> 00:09:35,360
A major heart attack caused
190
00:09:35,480 --> 00:09:38,160
60-year-old Russell's
heart to stop beating
191
00:09:38,280 --> 00:09:39,800
while he was at work.
192
00:09:39,920 --> 00:09:43,280
Paramedics got it going again
and raced him to Gold Coast
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00:09:43,400 --> 00:09:48,120
University Hospital, where Doctor
Ravi Batra is about to investigate.
194
00:09:49,640 --> 00:09:50,760
Ready for the diagnostic.
195
00:09:50,880 --> 00:09:52,760
Ravi injects a dye directly
196
00:09:52,880 --> 00:09:58,240
into Russell's heart that will
show up any blockages on the X-ray.
197
00:09:58,360 --> 00:10:00,680
It doesn't take long
to find the culprit.
198
00:10:00,800 --> 00:10:03,560
This is what we call
as the left main artery,
199
00:10:03,680 --> 00:10:05,600
which then divides
into two main arteries.
200
00:10:05,720 --> 00:10:08,560
If you notice here,
there's an abrupt reclusion here.
201
00:10:08,680 --> 00:10:11,760
There is no arteries running down
that area, it's barren.
202
00:10:11,880 --> 00:10:13,960
That's where it is blocked.
203
00:10:14,080 --> 00:10:16,000
With part of its blood
supply blocked,
204
00:10:16,120 --> 00:10:18,280
Russell's heart couldn't cope.
205
00:10:18,400 --> 00:10:21,160
Ravi tries to clear
the blockage using a fine wire...
206
00:10:21,280 --> 00:10:23,760
So be in that one?
Yes, please.
207
00:10:23,880 --> 00:10:27,280
..carefully fed in through the
access point in Russell's groin.
208
00:10:27,400 --> 00:10:30,400
Ok, good. Can I have
the wire now?
209
00:10:32,240 --> 00:10:35,120
So we now start to try
and open that artery.
210
00:10:35,240 --> 00:10:38,720
We start out by passing that wire.
And by me passing down the wire,
211
00:10:38,840 --> 00:10:42,000
we can see that some flow have been
down that blocked artery now.
212
00:10:42,120 --> 00:10:46,760
The flow has improved but the
artery is not staying open.
213
00:10:46,880 --> 00:10:49,120
Give me a 315 stent, please.
Yes.
214
00:10:49,240 --> 00:10:52,680
The stent is a mesh tube
that can be fed in, compressed
215
00:10:52,800 --> 00:10:56,440
and then expanded to form a
scaffold inside Russell's artery.
216
00:10:57,680 --> 00:11:02,240
It looks good at the spot
where I put in the stent.
217
00:11:02,360 --> 00:11:06,200
But there are some lesions, that's
clear as well, which either are
218
00:11:06,320 --> 00:11:11,320
a lesion I have missed or it is
an artery which is in spasm.
219
00:11:11,440 --> 00:11:12,800
The stent has worked.
220
00:11:12,920 --> 00:11:17,360
But where the reinforcing stops,
the artery continues to collapse.
221
00:11:17,480 --> 00:11:20,960
If Ravi can't make a repair quickly,
Russell will have permanent
222
00:11:21,080 --> 00:11:23,520
heart damage or even lose his life.
223
00:11:34,120 --> 00:11:38,160
60-year-old Russell has just
suffered a major heart attack.
224
00:11:38,280 --> 00:11:41,600
Doctor Ravi Batra has found
the blocked artery in his heart
225
00:11:41,720 --> 00:11:42,960
but there's a problem.
226
00:11:43,080 --> 00:11:46,640
There are some lesions, that's
clear as well, which either are
227
00:11:46,760 --> 00:11:50,080
a lesion I have missed or it is
an artery which is in spasm.
228
00:11:50,200 --> 00:11:54,400
A section of artery right next to
the blockage has now collapsed.
229
00:11:58,680 --> 00:12:00,640
Ravi goes in again.
230
00:12:00,760 --> 00:12:04,040
A second stent is fed all the way
into the damaged blood vessel
231
00:12:04,160 --> 00:12:05,160
in Russell's heart...
232
00:12:07,320 --> 00:12:08,560
OK, it's going up.
233
00:12:08,680 --> 00:12:12,240
..and this time
the artery stays open.
234
00:12:12,360 --> 00:12:16,120
The result after putting the second
scan, which is a fairly good result.
235
00:12:16,240 --> 00:12:20,360
Then we pull out everything,
make sure the result looks good,
236
00:12:20,480 --> 00:12:22,440
which it does.
I'm happy with the result.
237
00:12:22,560 --> 00:12:25,840
Russell's heart looks
to have escaped serious damage,
238
00:12:25,960 --> 00:12:29,200
but for his brain that was starved
of blood for four minutes,
239
00:12:29,320 --> 00:12:30,800
it could be a different story.
240
00:12:30,920 --> 00:12:33,880
Open this.
241
00:12:34,000 --> 00:12:36,640
Went well as far as the
cardiac procedure is concerned.
242
00:12:36,760 --> 00:12:41,400
What is of concern now is what
neurological damage has happened
243
00:12:41,520 --> 00:12:44,320
while he was in cardiac arrest.
244
00:12:44,440 --> 00:12:46,960
I'm told the downtime
was about four minutes.
245
00:12:47,080 --> 00:12:49,440
So basically it's
the neurological recovery,
246
00:12:49,560 --> 00:12:51,520
we have to wait and watch now.
247
00:12:57,440 --> 00:13:02,480
A week later, when Russell wakes up,
he has no idea what happened.
248
00:13:02,600 --> 00:13:06,480
Why are you in hospital, Russell?
What happened to you?
249
00:13:06,600 --> 00:13:08,120
What happened to me?
Yeah.
250
00:13:08,240 --> 00:13:09,760
That put you in hospital.
251
00:13:12,320 --> 00:13:14,360
I think I must have
collapsed somewhere or...
252
00:13:14,480 --> 00:13:15,720
Such a jumbled mind.
253
00:13:15,840 --> 00:13:20,120
Luckily his memory loss is just
temporary but for his family
254
00:13:20,240 --> 00:13:21,840
it's still a concern.
255
00:13:21,960 --> 00:13:24,120
That short-term memory
has gone, at the moment.
256
00:13:24,240 --> 00:13:27,040
We need to get it back.
257
00:13:27,160 --> 00:13:29,080
We're gonna put you in
the garage and fix you up.
258
00:13:29,200 --> 00:13:30,640
Yeah. (LAUGHS)
259
00:13:30,760 --> 00:13:33,920
It will be a couple of weeks
in a dedicated rehab
260
00:13:34,040 --> 00:13:35,880
before Russell's brain bounces back.
261
00:13:36,000 --> 00:13:38,480
See ya!
See you, Russell.
262
00:13:38,600 --> 00:13:41,920
And, miraculously,
a few months later,
263
00:13:42,040 --> 00:13:44,800
a fit and fully recovered
Russell returned to work.
264
00:14:04,400 --> 00:14:06,400
Dave has been a two-pack-a-day man
265
00:14:06,520 --> 00:14:09,080
most of his life,
and his black toes are
266
00:14:09,200 --> 00:14:11,120
just the tip of the iceberg.
267
00:14:11,240 --> 00:14:13,840
The problem with
Dave's blood circulation starts
268
00:14:13,960 --> 00:14:15,560
way up in his belly.
269
00:14:15,680 --> 00:14:18,080
So this is an X-ray
of the blood supply through
270
00:14:18,200 --> 00:14:20,680
Mr Enis' abdomen
to his legs and this here,
271
00:14:20,800 --> 00:14:23,360
you'll see, is the main artery
coming down though his tummy.
272
00:14:23,480 --> 00:14:26,480
To the trained eye,
it's a horrifying picture.
273
00:14:26,600 --> 00:14:30,120
And you can see that that main
artery is blocked completely there
274
00:14:30,240 --> 00:14:32,920
and there is no artery visible here.
275
00:14:33,040 --> 00:14:36,120
What you can just see are the
shadows of the calcium which is
276
00:14:36,240 --> 00:14:39,720
part of the stuff that's blocked the
artery and we will be looking to
277
00:14:39,840 --> 00:14:44,240
do a bypass from up here, using
a little graft shaped like a pair
278
00:14:44,360 --> 00:14:46,560
of trousers, where one of them
will go down to that side
279
00:14:46,600 --> 00:14:47,800
and one to this side.
280
00:14:47,920 --> 00:14:50,760
What you can also see on this X-ray
is on the right hand side, which is
281
00:14:50,880 --> 00:14:54,240
the good leg, the artery that goes
through the thigh down into
282
00:14:54,360 --> 00:14:56,120
the lower leg, this artery here,
283
00:14:56,240 --> 00:15:00,320
is still open but it's missing on
the left and we plan to replace
284
00:15:00,440 --> 00:15:01,560
that artery as well.
285
00:15:01,680 --> 00:15:03,680
Thanks very much.
We'll see ya, then.
286
00:15:03,800 --> 00:15:07,640
Dave really has done a job on
himself. Replacing nearly a metre
287
00:15:07,760 --> 00:15:10,680
of artery will be major surgery.
288
00:15:10,800 --> 00:15:12,480
My god.
289
00:15:14,320 --> 00:15:17,600
Are you all going to be there?
290
00:15:17,720 --> 00:15:19,240
Yeah, look, he's in trouble.
291
00:15:19,360 --> 00:15:22,800
The truth is if he doesn't have the
surgery he will lose a leg in due
292
00:15:22,920 --> 00:15:25,840
course anyway so this
is leg-saving surgery.
293
00:15:25,960 --> 00:15:29,880
If Dave is going to make a recovery
from the surgery, it's going to mean
294
00:15:30,000 --> 00:15:31,880
kicking his lifelong habit.
295
00:15:32,000 --> 00:15:35,880
Any operation we do for him
is adversely affected by
296
00:15:36,000 --> 00:15:37,480
ongoing cigarette smoking.
297
00:15:37,600 --> 00:15:40,920
No, I won't be smoking again,
as far as I can see.
298
00:15:41,040 --> 00:15:43,040
But I say that now, who knows.
299
00:15:43,160 --> 00:15:47,080
In truth, if he continues to smoke
I think it may be more likely that
300
00:15:47,200 --> 00:15:51,000
he will have a heart attack and that
will be the cause of his death.
301
00:16:04,760 --> 00:16:07,680
16-year-old Cooper's eye
was split in half
302
00:16:07,800 --> 00:16:11,320
by a golf ball in a freak
accident at a golfing range.
303
00:16:11,440 --> 00:16:14,160
Essentially, it's a bit
of a bright light.
304
00:16:14,280 --> 00:16:18,680
The accident has left him permanently
blind in one eye and today,
305
00:16:18,800 --> 00:16:21,160
he's seeing ophthalmologist
Doctor Sharon Morris
306
00:16:21,280 --> 00:16:23,080
to discuss the next step.
307
00:16:23,200 --> 00:16:26,960
I just want to get back
to doing normal stuff,
308
00:16:27,080 --> 00:16:30,560
it's just more sick of it
than worrying about it.
309
00:16:30,680 --> 00:16:35,240
Starting to get more frustrating,
I think, than... anything.
310
00:16:35,360 --> 00:16:38,440
As much as I haven't got one eye,
I can't do anything about it
311
00:16:38,560 --> 00:16:41,920
so I'm just... what can we
do to finish it?
312
00:16:42,040 --> 00:16:44,280
Just so I can start playing footie.
313
00:16:44,400 --> 00:16:48,840
Cooper has always dreamed of playing
Rugby League at an elite level
314
00:16:48,960 --> 00:16:51,800
and he's looking for the best way
to get back on the field.
315
00:16:51,920 --> 00:16:53,520
The two options that are available
316
00:16:53,640 --> 00:16:56,320
to you are whether we
keep your eye there.
317
00:16:56,440 --> 00:17:01,360
We manage the comfort and the pain,
eventually it will settle down.
318
00:17:01,480 --> 00:17:04,680
The other option
is taking your eye away
319
00:17:04,800 --> 00:17:07,000
because of the extent of trauma,
320
00:17:07,120 --> 00:17:10,200
we would actually have to take
the muscles off the eyeball,
321
00:17:10,320 --> 00:17:15,400
take away the whole eye itself,
including the white coat of the eye.
322
00:17:15,520 --> 00:17:17,600
Replace it with a ball implant
323
00:17:17,720 --> 00:17:20,520
and cover it all over with
your conjunctival tissue,
324
00:17:20,640 --> 00:17:21,920
the lining tissue of your eye.
325
00:17:22,040 --> 00:17:24,560
Although Cooper's eye
will never work again,
326
00:17:24,680 --> 00:17:26,840
removing it would be a big step.
327
00:17:26,960 --> 00:17:31,600
It's a major psychological trauma
and stress in terms of coping
328
00:17:31,720 --> 00:17:32,960
with losing an eye.
329
00:17:33,080 --> 00:17:36,400
It's a big journey. There's a lot to
deal with emotionally with regards
330
00:17:36,520 --> 00:17:39,040
to what it's gonna do,
how it's going to affect you,
331
00:17:39,160 --> 00:17:40,560
how you can do things in life,
332
00:17:40,680 --> 00:17:43,640
what it means for you
and it's a learning time.
333
00:17:43,760 --> 00:17:47,240
Cooper's family will help
him make this decision.
334
00:17:47,360 --> 00:17:49,000
I'm not sure what to say
about everything.
335
00:17:49,120 --> 00:17:52,400
Just... I'd be happy just to do
336
00:17:52,520 --> 00:17:55,560
whatever they think
is best but I don't know.
337
00:17:55,680 --> 00:17:58,400
But ultimately, this is one call
the young fella
338
00:17:58,520 --> 00:18:01,320
will have to make himself.
339
00:18:15,440 --> 00:18:18,960
It's been two months since
16-year-old Cooper was hit in the eye
340
00:18:19,080 --> 00:18:21,200
with a golf ball at a driving range.
341
00:18:21,320 --> 00:18:25,320
The golf ball ruptured his right
eyeball, leaving it permanently blind
342
00:18:25,440 --> 00:18:28,920
but this levelheaded bloke
won't let it get him down.
343
00:18:29,040 --> 00:18:32,400
I don't get sad,
I just get more annoyed at it,
344
00:18:32,520 --> 00:18:34,640
that I can't do certain things.
345
00:18:34,760 --> 00:18:37,320
I just take the positives
out of it, as in, like,
346
00:18:37,440 --> 00:18:38,680
it didn't hit me in the temple
347
00:18:38,800 --> 00:18:40,880
or it didn't hit me
in the back of the head.
348
00:18:41,000 --> 00:18:44,240
One positive the family is taking
from the accident is how it's made
349
00:18:44,360 --> 00:18:47,120
Cooper and his brother,
Logan, closer mates.
350
00:18:47,240 --> 00:18:49,960
Me and Coop,
before that accident happened,
351
00:18:50,080 --> 00:18:52,160
We were brothers
but we weren't friends.
352
00:18:52,280 --> 00:18:56,240
This whole thing's just basically
brought us together, like,
353
00:18:56,360 --> 00:18:58,840
he can talk to me, I can...
354
00:18:58,960 --> 00:19:01,840
Like, he's been at his friends and
he's like, "Oh, I need a lift home,
355
00:19:01,960 --> 00:19:03,840
"can you help us out?"
356
00:19:03,960 --> 00:19:05,640
And I'll just drop
everything for him.
357
00:19:05,760 --> 00:19:09,360
Logan has been helping Cooper
decide if it's worth keeping
358
00:19:09,480 --> 00:19:13,760
the unrepairable eye, with a lifetime
of upkeep to avoid infection,
359
00:19:13,880 --> 00:19:16,440
or if he's better off
having it removed.
360
00:19:16,560 --> 00:19:19,400
Just keen to get back to normality,
361
00:19:19,520 --> 00:19:22,680
just get back to everything
that I used to do with mates
362
00:19:22,800 --> 00:19:25,280
and footie and things.
363
00:19:25,400 --> 00:19:29,280
After giving it much thought, Cooper
has decided that having the eyeball
364
00:19:29,400 --> 00:19:32,240
taken out is going to
be the best option for him.
365
00:19:32,255 --> 00:19:33,520
How are you doing?
Good.
366
00:19:33,640 --> 00:19:35,840
Are you feeling alright?
Yeah.
367
00:19:35,960 --> 00:19:38,440
Doctor Sharon Morris is going
to take the eye out...
368
00:19:38,560 --> 00:19:41,800
So I'm going to put an
arrow on your right side.
369
00:19:41,920 --> 00:19:45,160
..and replace it with an orbital
implant that will get a hand-painted
370
00:19:45,280 --> 00:19:49,680
iris and pupil attached
that matches Cooper's good eye.
371
00:19:49,800 --> 00:19:53,720
Make sure we've got everything here,
make you comfortable as possible.
372
00:19:57,680 --> 00:20:01,240
Once Cooper's parents have wished
him luck, the team take him into
373
00:20:01,360 --> 00:20:02,680
the operating theatre,
374
00:20:02,800 --> 00:20:06,400
put him to sleep and prepare
to permanently remove the eye.
375
00:20:25,160 --> 00:20:26,520
Mum!
376
00:20:29,440 --> 00:20:32,560
Life is pretty sweet if you're a kid
growing up on the Gold Coast.
377
00:20:32,680 --> 00:20:33,760
Oh, bad luck!
378
00:20:33,880 --> 00:20:37,800
Take eight-year-old Jack. He doesn't
seem to have a care in the world.
379
00:20:37,920 --> 00:20:39,960
Should do your shoelaces
up a bit tighter.
380
00:20:40,080 --> 00:20:44,160
Except maybe that he still needs his
mum to tie his shoelaces for him
381
00:20:44,280 --> 00:20:46,400
but there's a special reason
for that,
382
00:20:46,520 --> 00:20:50,040
and that's something
they're hoping Professor Randy Bindra
383
00:20:50,160 --> 00:20:52,080
will be able to fix.
Very good, thank you.
384
00:20:52,200 --> 00:20:53,776
Nice to meet you, Doctor.
Good to see you.
385
00:20:53,800 --> 00:20:55,200
And you must be Jack?
This is Jack.
386
00:20:55,320 --> 00:20:57,000
How are you buddy? Good to see you.
Good.
387
00:20:57,120 --> 00:21:01,000
So heard you injured your thumb.
Is that right? What happened?
388
00:21:01,120 --> 00:21:05,000
Yeah. I was riding my bike
with a glass jar.
389
00:21:05,120 --> 00:21:07,280
A bike with a glass jar.
That's pretty cool.
390
00:21:07,400 --> 00:21:08,600
And I...
Like this?
391
00:21:08,720 --> 00:21:10,360
No.
Like that?
392
00:21:10,480 --> 00:21:15,280
No. Yeah, and I fell off and there
was a big bit of glass sticking out.
393
00:21:15,400 --> 00:21:17,520
Oh, boy.
And it went in.
394
00:21:17,640 --> 00:21:21,920
And we had X-rays and all the
nerves and everything
395
00:21:22,040 --> 00:21:23,040
were in place.
396
00:21:23,080 --> 00:21:25,840
Excellent, everything was in place.
But you can't move it very well?
397
00:21:25,960 --> 00:21:26,960
I can't bend it.
398
00:21:27,040 --> 00:21:29,480
How long ago did this happen?
He was six when that happened.
399
00:21:29,600 --> 00:21:33,600
At the time, it was just another
misadventure boys get themselves
400
00:21:33,720 --> 00:21:37,680
into, so Jack's mum, Elissa,
didn't think too much of it.
401
00:21:37,800 --> 00:21:40,040
There's where we had the glass
402
00:21:40,160 --> 00:21:44,240
go in there and then... Try bending.
403
00:21:44,360 --> 00:21:45,360
It goes straight.
404
00:21:45,480 --> 00:21:48,440
He goes across,
go to this and this side.
405
00:21:48,560 --> 00:21:50,720
Now go like this.
406
00:21:50,840 --> 00:21:53,040
Yeah...
See, no. We get nothing.
407
00:21:53,160 --> 00:21:55,520
I will say it and you write it down.
408
00:21:55,640 --> 00:21:58,160
OK. You ready?
Yep.
409
00:21:58,280 --> 00:22:00,000
Call.
410
00:22:00,120 --> 00:22:03,040
When it started to affect his
schoolwork, Jack did eventually
411
00:22:03,160 --> 00:22:06,560
pipe up that something
didn't feel quite right.
412
00:22:06,680 --> 00:22:11,320
I was writing and then I needed
a rubber 'cause I made a mistake
413
00:22:11,440 --> 00:22:14,040
and I rubbed it and
I couldn't feel my thumb
414
00:22:14,160 --> 00:22:16,080
and then I went and told Mum.
415
00:22:16,200 --> 00:22:19,520
It was a surprise to me because
I just thought he was going
416
00:22:19,640 --> 00:22:20,800
along normally.
417
00:22:20,920 --> 00:22:22,096
Now, I don't want to hurt you,
418
00:22:22,120 --> 00:22:24,520
so I'm just going to be
very gentle with this part.
419
00:22:24,640 --> 00:22:26,080
Does that bother you?
420
00:22:26,200 --> 00:22:29,840
No, but as you go down it hurts.
As I go further it could hurt?
421
00:22:29,960 --> 00:22:31,960
Yeah.
Got ya. OK.
422
00:22:32,080 --> 00:22:35,600
Having been turned away by numerous
other doctors, saying they either
423
00:22:35,720 --> 00:22:39,240
couldn't see a problem or couldn't
fix it, Professor Bindra
424
00:22:39,360 --> 00:22:41,960
is their last hope.
OK?
425
00:22:52,360 --> 00:22:56,720
After a lifetime of heavy smoking,
62-year-old Dave is starting
426
00:22:56,840 --> 00:23:00,320
to get gangrene in his toes because
of blockages in his arteries.
427
00:23:00,440 --> 00:23:03,480
This guy, there's a particular
problem because he's got a blockage
428
00:23:03,600 --> 00:23:04,600
at two levels.
429
00:23:04,640 --> 00:23:06,536
Whenever you tinker with
a blood supply to the leg,
430
00:23:06,560 --> 00:23:08,400
there's a chance of
things going wrong
431
00:23:08,520 --> 00:23:11,440
and when things go wrong
patients can lose their leg.
432
00:23:11,560 --> 00:23:14,200
Are you guys ready?
Yeah.
433
00:23:14,320 --> 00:23:16,400
Are you ready, Andrew?
434
00:23:16,520 --> 00:23:21,440
Fixing a double blockage like this
is not only incredibly risky,
435
00:23:21,560 --> 00:23:24,040
it's also highly unusual,
436
00:23:24,160 --> 00:23:27,960
and Doctor Will Butcher is taking the
opportunity to teach the procedure
437
00:23:28,080 --> 00:23:30,520
to his senior trainee, Keegan.
438
00:23:30,640 --> 00:23:32,200
The training programme
is five years
439
00:23:32,320 --> 00:23:34,840
so he's got another 3.5 years to go.
440
00:23:34,960 --> 00:23:39,560
OK, so now you probably don't need
much more than from here to there.
441
00:23:39,680 --> 00:23:42,280
When I started 20-something
years ago,
442
00:23:42,400 --> 00:23:46,040
the training and surgery, it was
very daunting. Very frightening.
443
00:23:46,160 --> 00:23:49,960
You spend a lot of time looking
to your consultant bosses
444
00:23:50,080 --> 00:23:53,560
and your trainers and wondering
if you will ever get there...
445
00:23:53,680 --> 00:23:56,400
What you're doing,
that's the proper sound.
446
00:23:56,520 --> 00:23:57,760
Yeah.
447
00:23:57,880 --> 00:24:01,360
..and the growth
is almost imperceptible.
448
00:24:01,480 --> 00:24:04,200
You can't feel yourself
getting stronger or better
449
00:24:04,320 --> 00:24:07,440
or more capable
but you discover that
450
00:24:07,560 --> 00:24:10,120
gradually the skills
are acquired and you start
451
00:24:10,240 --> 00:24:11,840
to be able to manage better.
452
00:24:11,960 --> 00:24:15,920
In Dave's belly, Doctor Butcher's
worst fears are confirmed -
453
00:24:16,040 --> 00:24:17,760
the main artery taking blood down
454
00:24:17,880 --> 00:24:20,840
from his heart to both
legs is totally blocked.
455
00:24:20,960 --> 00:24:23,680
The main artery coming
down to his legs,
456
00:24:23,800 --> 00:24:25,600
so we're going to put
the clamp on up here
457
00:24:25,720 --> 00:24:29,840
and then I'm gonna clean this
section out to put the graft on.
458
00:24:29,960 --> 00:24:33,280
OK? Then we'll tunnel
the graft down to the groin.
459
00:24:33,400 --> 00:24:34,920
Off you go, Keegan.
460
00:24:35,040 --> 00:24:38,800
With a tunnel in each leg ready
to get the replacement artery,
461
00:24:38,920 --> 00:24:41,520
Will removes the source
of Dave's problems,
462
00:24:41,640 --> 00:24:47,440
a massive blood clot that so
easily could have killed him.
463
00:24:47,560 --> 00:24:50,160
This is the cork we've
taken out of the aorta,
464
00:24:50,280 --> 00:24:52,120
that's just all blood clot.
465
00:24:52,240 --> 00:24:53,800
We call that 'atheroma'
466
00:24:53,920 --> 00:24:59,240
and it's mostly made up of scar
tissue that forms in the artery,
467
00:24:59,360 --> 00:25:02,360
as a response to injury
and in this case
468
00:25:02,480 --> 00:25:04,600
injury would be cigarette smoking.
469
00:25:04,720 --> 00:25:10,040
It's mostly just damaged cells and
cholesterol and some calcification.
470
00:25:10,160 --> 00:25:12,280
And if you look into
the abdominal cavity,
471
00:25:12,400 --> 00:25:15,240
you can see where I've opened up
that artery and cleared it out.
472
00:25:15,360 --> 00:25:17,560
So now we're gonna stitch
our graft onto here
473
00:25:17,680 --> 00:25:19,760
and then run it down to the groin.
474
00:25:19,880 --> 00:25:24,400
Incredibly, the blood supply to
Dave's legs now rely permanently
475
00:25:24,520 --> 00:25:27,000
on a man-made spare part.
476
00:25:27,120 --> 00:25:29,320
So this is the graft.
477
00:25:29,440 --> 00:25:33,600
So it's a fabric called Dacron. This
is made in a factory in Scotland.
478
00:25:36,200 --> 00:25:39,280
The graft must be perfectly
attached to the big artery.
479
00:25:39,400 --> 00:25:43,440
But there's no room for error,
because it came undone
480
00:25:43,560 --> 00:25:45,520
Dave wouldn't survive.
481
00:25:45,640 --> 00:25:48,240
This is quite tricky.
Mmm.
482
00:25:57,400 --> 00:26:00,400
Ophthalmologist Sharon Morris
is about to remove
483
00:26:00,520 --> 00:26:05,160
16-year-old Cooper's eyeball to
make way for a prosthetic implant.
484
00:26:05,280 --> 00:26:06,960
First step is, basically,
485
00:26:07,080 --> 00:26:09,080
lots of anaesthetic
around the eye socket
486
00:26:09,200 --> 00:26:12,360
and then creating lots of
anaesthetic underneath,
487
00:26:12,480 --> 00:26:14,320
the conjunctiva because
this conjunctiva
488
00:26:14,440 --> 00:26:16,680
is what we need to preserve.
489
00:26:16,800 --> 00:26:20,680
The last six weeks have been a tough
blow for the champion sportsman,
490
00:26:20,800 --> 00:26:24,000
whose eyeball was split in half
in a freak golfing accident
491
00:26:24,120 --> 00:26:28,040
that has left him
completely blind in one eye.
492
00:26:28,160 --> 00:26:32,440
The four main muscles that move
the eye up, down, left and right
493
00:26:32,560 --> 00:26:37,440
are carefully detached so they can
be reattached to the implant.
494
00:26:37,560 --> 00:26:41,360
The optic nerve is cut
and the eyeball is lifted out.
495
00:26:43,640 --> 00:26:44,640
All right.
496
00:26:47,760 --> 00:26:50,520
The ball implant
has got a coating round it.
497
00:26:50,640 --> 00:26:52,880
We're using a specially-made
bioceramic ball implant,
498
00:26:53,000 --> 00:26:58,280
where the white will wrap. Comes
pre-made and allows me to suture
499
00:26:58,400 --> 00:27:02,440
the muscles directly onto
the wrap. Can come out now.
500
00:27:02,560 --> 00:27:04,240
Sits beautifully in there.
501
00:27:04,360 --> 00:27:06,760
Tying muscles on now.
502
00:27:06,880 --> 00:27:10,080
Sharon connects the four
muscles to the implant.
503
00:27:10,200 --> 00:27:14,360
And what we are going to do now
is place a conformer shell
504
00:27:14,480 --> 00:27:19,200
in over the top of that
to help the lid stay formed.
505
00:27:19,320 --> 00:27:21,600
So... put it in now.
506
00:27:25,760 --> 00:27:28,240
For the next six to eight weeks,
507
00:27:28,360 --> 00:27:32,480
those lids will be very slightly
open because of the conformer.
508
00:27:32,600 --> 00:27:34,680
And they'll see the clear plastic
509
00:27:34,800 --> 00:27:37,600
that'll form a shell there
with the holes in.
510
00:27:37,720 --> 00:27:41,560
It may be unusual looking
but the conformer is making room
511
00:27:41,680 --> 00:27:45,280
for a realistic iris that will move
in sync with Cooper's good eye
512
00:27:45,400 --> 00:27:48,600
when this process is all over.
513
00:28:01,480 --> 00:28:05,640
Doctor Will Butcher and his senior
trainee, Keegan, have just removed
514
00:28:05,760 --> 00:28:09,560
a massive killer clot from Dave's
belly formed after
515
00:28:09,680 --> 00:28:12,520
years of smoking.
Look how nice that is.
516
00:28:12,640 --> 00:28:15,840
Keegan. This looks pretty good.
517
00:28:15,960 --> 00:28:19,520
There's the artery with
the graft attached to it now.
518
00:28:19,640 --> 00:28:21,840
Cool and now we're just
gonna run those to the binds.
519
00:28:23,960 --> 00:28:28,680
His main artery was so blocked,
it's replaced with a synthetic one.
520
00:28:28,800 --> 00:28:33,720
It's a delicate procedure
as there are other blocked veins
521
00:28:33,840 --> 00:28:36,600
which also need to be repaired
and replaced.
522
00:28:36,720 --> 00:28:39,440
That's our vein that we're
gonna do the graft with.
523
00:28:46,120 --> 00:28:50,400
So we have got to a point
now where we have done
524
00:28:50,520 --> 00:28:52,680
all of the top bit and we just need
525
00:28:52,800 --> 00:28:54,280
to join that on down there.
526
00:28:57,600 --> 00:28:58,600
Slowly.
527
00:29:01,080 --> 00:29:02,760
Now.
528
00:29:02,880 --> 00:29:04,840
And there it is,
down where we need it.
529
00:29:04,960 --> 00:29:08,840
Once all the new veins are in place,
Will sets Keegan the challenge of
530
00:29:08,960 --> 00:29:14,720
making the final link in the new
blood supply to Dave's lower leg.
531
00:29:14,840 --> 00:29:16,800
You and Gabby do that and estenosis,
532
00:29:16,920 --> 00:29:18,136
Ku, come round here and do this
533
00:29:18,160 --> 00:29:20,280
and, Andrea, can you
help me close the tummy?
534
00:29:21,800 --> 00:29:27,480
It's taken nearly four hours to
create the double artery bypass.
535
00:29:27,600 --> 00:29:31,160
The big question now is,
when they take off the clamps,
536
00:29:31,280 --> 00:29:36,520
will the veins hold and will blood
come back into Dave's foot.
537
00:29:47,440 --> 00:29:49,520
Eight-year-old Jack
can't bend his thumb
538
00:29:49,640 --> 00:29:53,240
and Professor Randy Bindra
is trying to find out why.
539
00:29:53,360 --> 00:29:56,920
I don't want to hurt you so I'm just
gonna be very gentle with this part.
540
00:29:57,040 --> 00:29:58,440
Does that bother you?
541
00:29:58,560 --> 00:30:02,480
No, but as you go down it hurts.
As I go further, it could hurt.
542
00:30:02,600 --> 00:30:04,240
Yeah.
Got you. OK.
543
00:30:04,360 --> 00:30:07,880
Professor Bindra suspects that
because the accident happened over
544
00:30:08,000 --> 00:30:11,400
a year ago, the tendon has shrunk
back all the way from Jack's thumb
545
00:30:11,520 --> 00:30:14,200
into his wrist.
Keep nice and still there.
546
00:30:14,320 --> 00:30:17,000
A simple X-ray will show
Randy what's going on.
547
00:30:18,000 --> 00:30:21,000
So what the report is
saying is what I suspected,
548
00:30:21,120 --> 00:30:23,080
that the tendon
is completely ruptured.
549
00:30:23,200 --> 00:30:26,040
So there's the thumb
bone right there. OK.
550
00:30:26,160 --> 00:30:28,880
Imagine the thumb lying this, OK?
Yeah.
551
00:30:29,000 --> 00:30:31,600
So here's a thumb. And normally
there should be a tendon in there.
552
00:30:31,640 --> 00:30:35,880
OK? And the tendon usually appears
like a black shadow in there.
553
00:30:36,000 --> 00:30:38,760
Surgery is needed, absolutely. Yes.
Yeah.
554
00:30:38,880 --> 00:30:40,280
Does it have to get cut?
555
00:30:40,400 --> 00:30:42,480
Yeah, I'll give you
a nice, cool scar.
556
00:30:42,600 --> 00:30:44,000
Oh!
557
00:30:44,120 --> 00:30:47,320
It'll be like a Spiderman scar,
you can shoot webs from that.
558
00:30:47,440 --> 00:30:51,320
Surgery to repair the tendon will
mean a few weeks with his right hand
559
00:30:51,440 --> 00:30:54,920
out of action, but Jack is
focusing on the positives.
560
00:30:55,040 --> 00:31:01,240
I can get a week off school.
Fingers crossed.
561
00:31:01,360 --> 00:31:04,560
Well, all fingers,
just not his thumb.
562
00:31:04,680 --> 00:31:07,920
So today Professor Randy Bindra
will try and return movement
563
00:31:08,040 --> 00:31:10,680
to the tip of Jack's thumb
with a tendon repair.
564
00:31:13,160 --> 00:31:15,360
Normally repairing
a tendon is straightforward,
565
00:31:15,480 --> 00:31:18,360
because when you cut a tendon you
find the two ends and repair it.
566
00:31:18,480 --> 00:31:21,960
What happened in Jack's case is
he cut it about 18 months ago.
567
00:31:22,080 --> 00:31:25,200
We don't have a good idea
of the condition of the tendon,
568
00:31:25,320 --> 00:31:28,200
whether it'll be tight,
because naturally muscles tighten.
569
00:31:28,320 --> 00:31:31,840
As they are cut and so it may
be quite shrunk down.
570
00:31:31,960 --> 00:31:33,600
We may not be able
to reach it through.
571
00:31:33,720 --> 00:31:35,920
So that pathway could be shut down.
572
00:31:36,040 --> 00:31:37,920
So right now, I don't know.
573
00:31:38,040 --> 00:31:41,720
Randy is hoping for the best,
but time will tell.
574
00:31:52,880 --> 00:31:56,200
Because of a massive clot in his
veins caused by a lifetime
575
00:31:56,320 --> 00:31:59,960
of smoking, Dave's legs
have been starved of blood.
576
00:32:00,080 --> 00:32:02,760
His toes literally turned black.
577
00:32:05,560 --> 00:32:08,800
After four hours of painstaking
surgery to remove clots
578
00:32:08,920 --> 00:32:10,440
and repair veins,
579
00:32:10,560 --> 00:32:14,000
the moment has come for Will
and his trainee, Keegan, to see
580
00:32:14,120 --> 00:32:16,240
if the operation has been a success.
581
00:32:18,680 --> 00:32:21,040
That's good, that's low resistance.
582
00:32:22,920 --> 00:32:24,840
I'm happy with that.
583
00:32:24,960 --> 00:32:27,400
Thank you. That sounds good.
584
00:32:27,520 --> 00:32:29,960
Keegan, you can stop looking
at it now and put it away.
585
00:32:30,080 --> 00:32:33,440
It's the greatest thing as
a surgeon to watch somebody
586
00:32:33,560 --> 00:32:35,880
you've trained turn
into a good surgeon.
587
00:32:36,000 --> 00:32:40,240
Replacing two sections of blocked
artery has returned good blood flow
588
00:32:40,360 --> 00:32:43,840
to Dave's lower leg
and the improvement is instant.
589
00:32:43,960 --> 00:32:45,880
So now it's nicer feet.
590
00:32:46,000 --> 00:32:47,040
Look at that.
591
00:32:48,280 --> 00:32:49,640
Now it's time to warm up, already.
592
00:32:49,760 --> 00:32:52,440
But if Dave is going
to get back on his feet,
593
00:32:52,560 --> 00:32:56,240
the lifelong smoker will have
to kick his pack-a-day habit.
594
00:32:56,360 --> 00:32:58,376
You'd think that an operation
like this might frighten them
595
00:32:58,400 --> 00:33:00,840
into doing it,
it's not always true.
596
00:33:00,960 --> 00:33:03,416
But you've got to give it up right
now. Packet of cigarettes now cost,
597
00:33:03,440 --> 00:33:07,040
what, close to 30 bucks? Some of
these guys are smoking more
598
00:33:07,160 --> 00:33:09,600
than a packet a day.
That's a lot of money.
599
00:33:09,720 --> 00:33:14,120
Holy mackerel. Wow!
600
00:33:16,400 --> 00:33:19,200
I get to venture outside?
You do, into the outside world.
601
00:33:19,320 --> 00:33:20,480
Oh. Alright.
602
00:33:20,600 --> 00:33:24,800
A few days later, the foot is on the
way to making a full recovery from
603
00:33:24,920 --> 00:33:28,960
the early stages of gangrene
and Dave has got his plan in place
604
00:33:29,080 --> 00:33:30,640
to stay off the smokes.
605
00:33:30,760 --> 00:33:32,200
I think I can beat it.
606
00:33:32,320 --> 00:33:35,120
It's the best chance I've got. It's
the first time I've had a real good
607
00:33:35,160 --> 00:33:38,600
chance of stopping, so,
608
00:33:38,720 --> 00:33:43,080
I'll be determined to stop.
609
00:33:43,200 --> 00:33:47,760
And I've got my mates who will have
a go at me if I try and pick one up,
610
00:33:47,880 --> 00:33:49,600
so that's the main thing.
611
00:33:49,720 --> 00:33:53,640
Just try and slow your breathing
down a little bit there.
612
00:33:53,760 --> 00:33:56,000
Take nice, slow, deep breaths.
613
00:33:56,120 --> 00:33:59,040
It he doesn't give up smoking
and he doesn't reform his life,
614
00:33:59,160 --> 00:34:00,640
we've, in some ways, we've failed
615
00:34:00,760 --> 00:34:04,160
because we've failed to take the
opportunity to help him to reform
616
00:34:04,280 --> 00:34:08,280
his lifestyle and look after
himself a little bit better.
617
00:34:08,400 --> 00:34:09,560
But he's a pretty good guy,
618
00:34:09,680 --> 00:34:15,520
I think he's changeable.
I think he will come good.
619
00:34:15,640 --> 00:34:18,360
I can feel it getting better,
everything's getting better,
620
00:34:18,480 --> 00:34:19,920
quicker, each day.
621
00:34:20,040 --> 00:34:22,200
I might be up roller skating by
622
00:34:22,320 --> 00:34:24,960
the end of the weekend. (LAUGHS)
623
00:34:25,080 --> 00:34:27,720
Break a leg. (LAUGHS)
624
00:34:36,440 --> 00:34:39,400
Eight-year-old Jack
is having surgery on his thumb
625
00:34:39,520 --> 00:34:41,120
so he will be able to bend it...
626
00:34:41,240 --> 00:34:42,640
He's putting himself to sleep, huh?
627
00:34:42,720 --> 00:34:45,680
..but when Randy opens
up the hand and goes looking
628
00:34:45,800 --> 00:34:49,680
for the ends of the severed tendon,
there's bad news.
629
00:34:49,800 --> 00:34:54,560
Normally there were tendons sitting
there, this looks hollow and flat.
630
00:34:54,680 --> 00:34:56,760
So we expect the tendon to be
normally right here,
631
00:34:56,880 --> 00:34:58,920
right in the middle there,
and I don't see
632
00:34:59,040 --> 00:35:02,840
any tendon so obviously the tendon
has retracted even at the other end,
633
00:35:02,960 --> 00:35:04,120
which is not usual.
634
00:35:04,240 --> 00:35:08,080
He's very scarred all the way
down to the end there.
635
00:35:08,200 --> 00:35:11,720
The two loose ends of the tendon
have shrivelled out of sight,
636
00:35:11,840 --> 00:35:15,480
and the area where they should be
joined is full of scar tissue
637
00:35:15,600 --> 00:35:17,080
from the glass cut injury.
638
00:35:17,200 --> 00:35:18,200
There we go.
639
00:35:18,240 --> 00:35:21,680
We've finally found a normal piece
of tendon, but way down there,
640
00:35:21,800 --> 00:35:25,520
so obviously both ends of the
tendon shrivel away quite a lot.
641
00:35:25,640 --> 00:35:28,400
So all I have here is a little
bit of tendon, you see it?
642
00:35:28,520 --> 00:35:32,080
I'm onto that with my hook.
So there's the end.
643
00:35:32,200 --> 00:35:36,840
Great. So he's shot up all
the way up to there from here.
644
00:35:36,960 --> 00:35:39,080
So it has really
shrivelled down quite a lot.
645
00:35:39,200 --> 00:35:42,000
Now what we want to do is find
the other end of the tendon here
646
00:35:42,120 --> 00:35:43,360
and make a passageway.
647
00:35:43,480 --> 00:35:47,280
Randy is planning to use a piece of
spare tendon from Jack's forearm
648
00:35:47,400 --> 00:35:50,120
to rejoin the separate ends
of the thumb flexor.
649
00:35:50,240 --> 00:35:53,280
So this is his tendon back
here and then I pull on it.
650
00:35:53,400 --> 00:35:55,360
What it's doing
is pulling on his muscles
651
00:35:55,480 --> 00:35:57,280
and making the
thumb twitch like that,
652
00:35:57,400 --> 00:36:00,320
but it's not really reaching
to the end of his thumb. OK.
653
00:36:00,440 --> 00:36:04,560
The separate ends have been found
but they can't be joined today.
654
00:36:04,680 --> 00:36:07,920
Because my concern is,
he has got too much scar tissue
655
00:36:08,040 --> 00:36:11,000
and if I take his free tendon
today and put it in,
656
00:36:11,120 --> 00:36:13,520
it's just gonna get
wrapped up in the scar.
657
00:36:13,640 --> 00:36:17,560
So I'd be better off if I put the
plastic rod in there and come back
658
00:36:17,680 --> 00:36:19,880
a couple of months later
and then take out the rod.
659
00:36:20,000 --> 00:36:21,456
By then he'll have
a smooth passageway
660
00:36:21,480 --> 00:36:23,320
so the new tendon will glide easier.
661
00:36:26,560 --> 00:36:30,760
So I'm trying to slide this in so
that it goes nice and smooth
662
00:36:30,880 --> 00:36:34,640
without any, as they say
in Australia, without any drama.
663
00:36:34,760 --> 00:36:37,520
Those two. There we are.
664
00:36:37,640 --> 00:36:42,400
The silicon rod will be stitched in
place and left for a few months,
665
00:36:42,520 --> 00:36:45,720
then replaced with a section
of Jack's own spare tendon.
666
00:36:45,840 --> 00:36:47,800
Think that's a good length.
667
00:36:47,920 --> 00:36:51,200
That's the problem...
(LAUGHTER)
668
00:36:51,320 --> 00:36:53,920
It'd have been nice if you could get
it all done in one go, right?
669
00:36:54,000 --> 00:36:55,800
That way Jack doesn't
need two anaesthetics.
670
00:36:55,920 --> 00:36:58,520
But it was definitely
not worth progressing.
671
00:36:58,640 --> 00:37:02,160
I think if we did it all in one
stage and if it got stuck down
672
00:37:02,280 --> 00:37:03,656
he wouldn't have got a good outcome.
673
00:37:03,680 --> 00:37:06,840
Unfortunately, Jack will have
to stay off the soccer field
674
00:37:06,960 --> 00:37:08,840
for longer than he thought,
675
00:37:08,960 --> 00:37:10,880
but the end result will be worth it.
676
00:37:11,000 --> 00:37:13,600
It's gonna take a little bit longer
but we'll get there.
677
00:37:28,360 --> 00:37:31,560
Six-year-old Jack has had two
operations on his right hand
678
00:37:31,680 --> 00:37:34,560
to repair the flexor
tendon in his thumb.
679
00:37:34,680 --> 00:37:38,120
The first procedure found the two
ends of the tendon he severed on
680
00:37:38,240 --> 00:37:42,200
broken glass and left a plastic rod
forming a space between them.
681
00:37:42,320 --> 00:37:47,040
A month ago, the second operation
reconnected the tendon.
682
00:37:47,160 --> 00:37:50,400
We took a spare tendon from the back
of the index finger and we took out
683
00:37:50,520 --> 00:37:55,280
the plastic rod and we put
this tendon in that space.
684
00:37:55,400 --> 00:37:57,040
I haven't seen Jack
since the surgery
685
00:37:57,160 --> 00:38:00,320
so I'm quite excited to
see what the outcome is.
686
00:38:00,440 --> 00:38:02,560
Not having the use of his right hand
687
00:38:02,680 --> 00:38:04,760
for two months
has been hard for Jack,
688
00:38:04,880 --> 00:38:07,560
not to mention his big
sister Charlotte, too.
689
00:38:07,680 --> 00:38:10,320
It's basically like having
a two-year-old all over again.
690
00:38:10,440 --> 00:38:15,560
Can't do anything. It's hard for him
to hold like a fork and eat with
691
00:38:15,680 --> 00:38:17,120
his left and right.
692
00:38:17,240 --> 00:38:20,920
He can't do things that
an everyday boy can do.
693
00:38:21,040 --> 00:38:22,920
So you've been good
about your splint?
694
00:38:23,040 --> 00:38:24,320
Yeah.
No messing around.
695
00:38:24,440 --> 00:38:26,240
Was he good,
was he wearing it the whole time?
696
00:38:26,280 --> 00:38:27,840
You can tell on him.
Not all times.
697
00:38:27,960 --> 00:38:29,760
Not all times?
No.
698
00:38:29,880 --> 00:38:31,800
That doesn't sound good.
699
00:38:33,560 --> 00:38:34,680
Let's take a look.
700
00:38:36,280 --> 00:38:38,880
All right. Good.
701
00:38:39,000 --> 00:38:42,880
Go ahead and try and bend it for me
like this. Show me what he can do.
702
00:38:43,000 --> 00:38:46,360
Very good. And do this for me,
give me the perfect sign.
703
00:38:46,480 --> 00:38:47,600
That's really good there.
704
00:38:47,720 --> 00:38:49,720
Perfect.
Perfect.
705
00:38:49,840 --> 00:38:51,280
Great job. Excellent.
706
00:38:51,400 --> 00:38:54,720
Now... So the good news
is this is working.
707
00:38:54,840 --> 00:38:56,360
Working.
Right.
708
00:38:56,480 --> 00:38:59,600
We want to improve the range
of motion, we want to improve
709
00:38:59,720 --> 00:39:03,080
the mobility and at one month,
this is good for one month. OK?
710
00:39:03,200 --> 00:39:06,400
Now we want to try to increase the
movement in it and that will happen
711
00:39:06,520 --> 00:39:09,360
over the next two months and that's
when we'll increase the strength.
712
00:39:09,480 --> 00:39:13,640
A couple of months of physiotherapy
under the watchful eye of big sis
713
00:39:13,760 --> 00:39:16,840
and Jack's thumb will
be almost good as new.
714
00:39:16,960 --> 00:39:20,320
I'm just pleased that it works
so he can do things again.
715
00:39:20,440 --> 00:39:22,760
Thank you, Professor.
Oh, my pleasure.
716
00:39:22,880 --> 00:39:23,880
My pleasure.
OK.
717
00:39:24,000 --> 00:39:26,000
See you guys.
See you. Another one.
718
00:39:26,120 --> 00:39:28,560
Alright.
719
00:39:28,680 --> 00:39:30,320
Great stuff, thank you.
720
00:39:30,440 --> 00:39:32,480
I'm mostly looking forward
721
00:39:32,600 --> 00:39:34,240
to play football.
722
00:39:34,360 --> 00:39:35,640
Surfing in summer.
723
00:39:35,760 --> 00:39:37,880
And surfing in summer.
724
00:39:38,000 --> 00:39:39,280
Bye.
Bye.
725
00:39:39,400 --> 00:39:42,920
And it won't be long before Jack
can declare thumby wars again.
726
00:39:43,040 --> 00:39:46,520
..three, four,
I declare a thumb war.
727
00:39:58,920 --> 00:40:01,840
It's eye replacement day
for 16-year-old Cooper,
728
00:40:01,960 --> 00:40:05,960
whose right eye was split in half
in a freak golfing accident.
729
00:40:06,080 --> 00:40:08,320
Is it weeping?
No, it's all good.
730
00:40:08,440 --> 00:40:11,000
It's been a tough time
for the champion sportsman,
731
00:40:11,120 --> 00:40:14,480
whose budding footie
career has been on hold.
732
00:40:14,600 --> 00:40:19,120
Just keen to get back to normality
and everything like that.
733
00:40:19,240 --> 00:40:22,720
Just get back to everything that
I used to do with mates
734
00:40:22,840 --> 00:40:24,200
and footie and things.
735
00:40:24,320 --> 00:40:29,520
Ocularist Trevor Dorahy has been hand
making a prosthetic that will fit
736
00:40:29,640 --> 00:40:33,000
into the orbital implant
already in Cooper's socket.
737
00:40:33,120 --> 00:40:34,760
Everybody's iris is
738
00:40:34,880 --> 00:40:36,400
a different diameter.
739
00:40:36,520 --> 00:40:38,080
What I need to do is turn a button
740
00:40:38,200 --> 00:40:40,320
down to the same
diameter as their iris
741
00:40:40,440 --> 00:40:42,600
so I can paint the colour onto it.
742
00:40:42,720 --> 00:40:47,240
That then will be put
into a mould like this
743
00:40:47,360 --> 00:40:49,880
and I pack that with acrylic.
744
00:40:50,000 --> 00:40:52,760
And the coloured iris button is
covered with the white of the eye.
745
00:40:52,880 --> 00:40:55,880
Now what I will do
is cut that white off.
746
00:40:56,000 --> 00:40:57,480
A great result at the end of it.
747
00:40:57,600 --> 00:40:59,881
We get a lot more movement
because the eye's really light.
748
00:41:00,000 --> 00:41:01,480
It's not a solid eye.
749
00:41:03,200 --> 00:41:05,880
Good morning, Cooper. Come on in.
750
00:41:06,000 --> 00:41:09,320
After the trauma of the accident
and having his eyeball removed,
751
00:41:09,440 --> 00:41:11,960
today Cooper's life
can get back to normal.
752
00:41:13,680 --> 00:41:16,520
A big day.
Yeah.
753
00:41:16,640 --> 00:41:19,920
When you go to put that in, that
pointed part goes towards your nose.
754
00:41:33,920 --> 00:41:35,880
How's it feel? Cold?
755
00:41:36,000 --> 00:41:37,440
Yeah, it's a bit cold at the moment
756
00:41:37,560 --> 00:41:39,240
but it feels heaps better than
757
00:41:39,360 --> 00:41:42,080
what I had in there before.
OK, that's good.
758
00:41:42,200 --> 00:41:46,120
Cooper's eye muscles that were
reattached to the implant base
759
00:41:46,240 --> 00:41:50,160
gives the fake iris almost as
much movement as his real one.
760
00:41:50,280 --> 00:41:52,360
I want you to hold your
head perfectly still
761
00:41:52,480 --> 00:41:54,800
and I want you to roll your
eyes to the wall.
762
00:41:54,920 --> 00:41:57,360
Back.
763
00:41:58,920 --> 00:42:00,840
Up. And now we want it down.
764
00:42:02,480 --> 00:42:05,240
Very good. I'm happy with that.
765
00:42:05,360 --> 00:42:07,416
You'll find the movement
will get even better than that,
766
00:42:07,440 --> 00:42:09,880
it'll take a couple of weeks
but it'll be quite good.
767
00:42:10,000 --> 00:42:12,040
Would you like have a look at it?
768
00:42:19,240 --> 00:42:20,360
It's hectic as.
769
00:42:20,480 --> 00:42:24,000
"Hectic as" is not how Coop's
mum, Sharon, describes it.
770
00:42:24,120 --> 00:42:26,600
He looks fantastic.
Looks fantastic.
771
00:42:26,720 --> 00:42:28,200
We just think it looks amazing.
772
00:42:28,320 --> 00:42:29,720
Facial features, you know,
773
00:42:29,840 --> 00:42:31,200
you just sort of....
774
00:42:31,320 --> 00:42:32,880
Back to normal.
Yeah.
775
00:42:33,000 --> 00:42:35,040
Good luck with it.
It's really nice.
776
00:42:35,160 --> 00:42:36,600
OK. Thanks, mate.
777
00:42:36,720 --> 00:42:37,560
Cheers for that.
OK.
778
00:42:37,680 --> 00:42:42,280
And for this footie family, that
means Cooper's back on the field.
779
00:42:42,400 --> 00:42:44,720
He's handled everything amazingly.
780
00:42:44,840 --> 00:42:48,000
He's just never let it get in his
way, he's never let it get him down.
781
00:42:48,120 --> 00:42:51,560
I think it'll be the final
chapter of all the medical
782
00:42:51,680 --> 00:42:55,200
side of things but obviously
a new beginning for him.
783
00:42:55,320 --> 00:42:59,440
We're just really excited
to see the old Coop back.
784
00:43:06,040 --> 00:43:10,840
Next week on Gold Coast Medical,
top surgeons take on a challenge...
785
00:43:10,960 --> 00:43:12,360
We often do cases together.
786
00:43:12,480 --> 00:43:13,600
It's a concert.
787
00:43:13,720 --> 00:43:15,920
It's a concert without a conductor,
788
00:43:16,040 --> 00:43:17,160
right?
Yeah. (LAUGHS)
789
00:43:17,280 --> 00:43:20,640
..to perform a life changing
miracle on this gentle giant.
790
00:43:21,720 --> 00:43:25,360
A police officer watches over surgery
to see what this man
791
00:43:25,480 --> 00:43:26,640
has inside his body...
792
00:43:26,760 --> 00:43:30,680
OK, I need whoever took the
bullet out to actually give it
793
00:43:30,800 --> 00:43:34,880
to the policeman in
a pot as chain of evidence.
794
00:43:35,000 --> 00:43:36,840
Good.
..and a new life...
795
00:43:36,960 --> 00:43:38,240
You want me to catch it?
796
00:43:38,360 --> 00:43:39,680
..that doesn't start as planned.
797
00:43:39,800 --> 00:43:41,120
Captioned by Ai-Media
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